Bring the fight to breast cancer.
Diagnosis and what to expect
See how doctors diagnose breast cancer.
Breast cancer is usually diagnosed through imaging tests and other procedures like biopsies and biomarker tests, which help doctors learn more about the tumor. These tests can help determine the type of breast cancer you have and what it means for your treatment.
Have you asked about biomarker testing?
Biomarker testing can help your care team design a treatment plan tailored to you. We’ll help you build a discussion guide you can take to your next visit.
Not all types of breast cancer are the same.
Once diagnosed, doctors look at where the cancer started and certain features to determine the type of breast cancer. They may further determine type through biomarker testing.
While treatment usually depends on the cancer's stage, factors like where the cancer started, whether it is invasive, and certain biomarkers may also play a role.
Here are some of the terms you may hear.
Where the cancer starts
One way doctors describe breast cancer is by where it begins in the breast.
Ductal carcinoma
Ductal carcinoma starts in the milk ducts, which are the small tubes that carry milk to the nipple. It is the most common type of breast cancer.
Lobular carcinoma
Lobular carcinoma starts in the lobules, the glands where breast milk is produced. It is less common than ductal carcinoma.
How the cancer behaves
Doctors also look at certain features of the cancer cells, often called biomarkers, to better understand how the cancer may behave. For example, someone may have ductal breast cancer that is hormone receptor (HR)-positive, while another person may have lobular breast cancer that is HER2-positive.
HR-positive (HR+)
This subtype involves tumor cells with receptors for estrogen or progesterone hormones, which can promote tumor growth. These cancers tend to grow more slowly than hormone receptor-negative (HR–) cancers. They can often be treated with hormone therapy drugs.
HR-negative (HR–)
Breast cancers that are HR– do not have receptors for the hormones estrogen or progesterone. Because they are not driven by hormones, hormone therapy is usually not effective.
HER2-positive (HER2+)
HER2 is a protein that helps breast cancer develop faster. If breast cancer cells have higher than normal levels of HER2, they are classified as HER2-positive (HER2+).
HER2-negative (HER2–)
Breast cancers that do not overexpress the HER2 protein are classified as HER2–. This subtype makes up over 80% of female breast cancer cases.
Triple-negative breast cancer
This aggressive, invasive breast cancer is HER2– and lacks hormone receptors for estrogen and progesterone.
Understand breast cancer stages.
A stage defines how far the cancer has grown or spread, from early-stage to more advanced.
The TNM system helps determine the stage. It looks at tumor size (T), whether cancer is in lymph nodes (N), and whether it has spread to other parts of the body, or metastasized (M).
You may also hear about the cancer’s grade. A grade describes how normal or abnormal the cancer looks. Normal-looking cancers tend to be less aggressive, and grow more slowly, than abnormal-looking cancers.
Knowing your stage and grade helps you understand your cancer and helps guide your doctor’s treatment decisions.
Stage 0
At this stage, the cancer is non-invasive, meaning abnormal cells are present but have not spread beyond the ducts or lobules into nearby breast tissue.
Stage 1
Cancer has begun to spread into nearby breast tissue, meaning it is now invasive, but the tumor is still small and confined to the breast.
Stage 2
The tumor may be larger, or cancer may have spread to a few nearby lymph nodes, but it has not spread to distant parts of the body.
Stage 3
Cancer has spread more extensively to nearby lymph nodes or surrounding tissues, such as the chest wall or skin of the breast, but not to distant organs.
Stage 4
Cancer has spread beyond the breast and nearby lymph nodes to other parts of the body, such as the bones, liver, lungs, or brain. This is called metastatic breast cancer.
Ways to work with your care team
From questions to clarity, your doctor can help.
Diagnosis, testing, and treatment types can bring lots of questions. We can help prepare you to get the most out of your conversations.
Get answers about your diagnosis.
- What type of cancer do I have?
- Has it spread or grown?
- What stage is my cancer?
Talk about your treatment plan.
- What types of treatment are used for my cancer?
- If biomarker testing was done, how do the results impact my treatment plan?
- What are the goals of my treatment plan?
Ask about support and resources.
- What support services are available?
- Who can help me navigate care and next steps?
- Who on my care team can I reach out to when I have questions?
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Living with cancer
Get a little inspiration.
By the time I am in my 80s, I will say it [cancer] was just another bump in the road.”
Cynthia
Actual patient with breast cancer
A breast cancer diagnosis can be a comma, not a period.”
Karla
Actual patient with breast cancer
